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Introduction. Chronic pelvic pain negatively affects the quality of life (QoL) of patients with a painful form of external genital endometriosis (EGE) and adversely impacts on the physical, psychoemotional and sexual health of reproductive-age women resulting in distress, maladaptation, anxiety-depressive disorders, disrupted social functioning in family relationships. Aim: to assess the QoL of women with painful EGE after radical treatment in the rehabilitation period by using subjective research methods. Materials and Methods. We examined 104 female patients of reproductive age (42.4 ± 3.7 years) with painful EGE after radical treatment: group IA – 49 women underwent "active" rehabilitation, group IB – 55 patients underwent "passive" rehabilitation tactics in accordance with standards and National Clinical Guidelines. The assessment of QoL (subjective) was performed using specialized questionnaires: visual analog scale (VAS), PainDETECT questionnaire, Endometriosis Health Profile-30 (EHP-30) questionnaire, Hospital Anxiety and Depression Scale (HADS), Female Sexual Function Index (FSFI). Assessment of QoL parameters was carried out at 6 control time points: before, as well as 5–9 days, 1, 3, 6 and 12 months after surgical treatment. Results. Patients underwent "active" rehabilitation tactics (group IA) showed prominently reduced pain syndrome, neuropathic component of pain, anxiety-depressive disorders, normalized sexual function and improved all QoL parameters, unlike patients managed with "passive" tactics, who underwent a complex of rehabilitation measures within the framework of National Clinical Guidelines (group IB). More severe EGE course and significantly decreased QoL in patients with painful EGE at "passive" rehabilitation tactics were noted. Conclusion. Applying a complex personalized rehabilitation program along with multidisciplinary approach in patients with painful EGE after radical treatment can markedly improve overall well-being, timely correct psychoemotional and sexual dysfunction, and therefore prominently increase the patients' QoL.

Introduction. External genital endometriosis (EGE) is a chronic, relapsing disease that affects various aspects of sexual function, the quality of sexual and interpersonal relationships, physical and psycho-emotional health and leads to social maladjustment and anxiety-depressive disorders, resulting in progressively decreased quality of life (QoL).Aim: to analyze an impact of sexual disorders on QoL of women with painful and painless EGEs.Materials and Methods. A prospective comparative randomized interventional study involved 160 patients (110 and 50 women with painful and painless EGE, respectively) of reproductive age, with laparoscopically and morphologically verified diagnosis according to the revised American Fertility Society scoring system (R-AFS, 1996). Pain syndrome and sexual dysfunction were assessed using specialized questionnaires: visual analogue scale (VAS), PainDETECT, and Female Sexual Function Index (FSFI). After surgical treatment, 8 patients refused to participate in the study (6 with painful EGE and 2 with painless EGE). Thus, only 152 women passed all stages of the study. The patients were divided into 4 groups depending on the presence and/or absence of pain syndrome and the tactics of the rehabilitation period ("active" or "passive"): group IA consisted of 49 (47.1 %) women with pain and "active" rehabilitation; group IБ – 55 (52.9 %) women with pain syndrome and "passive" rehabilitation tactics; group IIA – 23 (47.9 %) patients without pain syndrome with "active" rehabilitation; group IIБ – 25 (52.1 %) patients without pain syndrome with "passive" rehabilitation tactics.Results. Women with painful vs. painless EGE were found to have a more severe course of the disease and a markedly decreased quality of sexual life. It was observed that patients with "active" rehabilitation tactics (groups IA and IIA) had intensity of the pain syndrome and the neuropathic pain component significantly decreased, improved parameters of the quality of sexual life, sexual desire and sexual excitability compared to patients with "passive" rehabilitation tactics applied with the measures within the framework of the National Clinical Guidelines (groups IБ and IIБ).Conclusion. A significantly decreased quality of sexual life of EGE patients indicates a need for assessing and correcting sexual disorders as well as introducing early onset of rehabilitation measures by using a multidisciplinary approach.

Introduction. Chronic pain syndrome with external genital endometriosis (EGE) causes profound psychoemotional changes, anxiety disorders, decreased physical and social activity, general well-being and mood, sexual dysfunction, and as a consequence, deteriorated quality of patients' life.Aim: to study an influence of psychoemotional disorders on the quality of life of women with painful and painless forms of EGE.Material and Methods. There were enrolled 160 patients (110 women with painful and 50 with painless forms of EGE) of reproductive age with laparoscopically and morphologically verified diagnosis, according to the Revised American Fertility Society score (R-AFS) classification. Pain syndrome and psychoemotional status were assessed using various quality of life assessment questionnaires: Visual Analog Scale (VAS), Endometriosis Health Profile-30 (EHP-30), Hospital Anxiety and Depression Scale (HADS). After surgical treatment, 8 patients refused to participate in the work (6 with painful form of EGE and 2 with painless form). Thus, 152 women passed all stages of the study. The patients were divided into 4 groups depending on the presence and/or absence of pain syndrome and tactics of the rehabilitation period ("active" or "passive"): group IA consisted of 49 (47.1 %) women with pain syndrome and "active" rehabilitation; group IБ – 55 (52.9 %) women with pain syndrome and "passive" rehabilitation tactics; group IIA – 23 (47.9 %) patients without pain syndrome and with "active" rehabilitation; group IIБ – 25 (52.1 %) patients without pain syndrome and with "passive" rehabilitation tactics.Results. It was found that painful vs. painless form of EGE differs by a more severe course of the disease and markedly decreased quality of life. In a comparative analysis of the four groups it was noted that women with "active" tactics of rehabilitation measures (IA and IIA) had a decrease in pain syndrome, improved emotional, social and sexual activity, decreased depression and anxiety scores as compared to the patients (IБ and IIБ) who underwent a set of rehabilitation measures within the National clinical guidelines.Conclusion. Timely diagnostics and correction of psychoemotional disorders will allow to develop a differentiated approach to provide specialized medical and psychological care and improve the quality of life of patients with EGE.

Hysterectomy currently occupies one of the leading places among obstetric and gynecological surgeries and is one of the highly effective and sometimes the only method of treating various diseases of the female genital organs. Quite often, however, hysterectomy results not only in the elimination of the cause of disease, but also in the development of complications that reduce the quality of life of patients. More and more attention is being paid to neurological complications, which is obviously due to improved diagnostic capabilities, as well as the results of recent research on the pathogenesis and treatment of neurological disorders. Only recently the scientists have begun to think about the true causes of one of the most important neurologic complications of hysterectomy, namely chronic postoperative pain.The review describes in detail the main neurological disorders that develop after hysterectomy: chronic postoperative pain, traumatic neuroma, residual ovarian syndrome as possible causes of chronic pain, mononeuropathies, sexual and sleep disorders, decreased cognitive and motor functions, lower urinary tract and bowel dysfunction. Considerable attention is given to the mechanisms of neurological complications and the relationship between the surgery and emotional disturbances in women.

Aim: to analyze current literature sources on endometriosis-associated cancer (ЕАС) in gynecology.Materials and Methods. We searched for publications in the international scientific databases: eLibrary, Google Scholar, ScienceDirect, Cochrane Library, PubMed/MEDLINE and clinical research registries. For this systematic analysis, only full-text publications were used. We evaluated the reliability of evidence and the methodological quality of the studies. The data on the modern approach to the therapy and rehabilitation of women with external genital endometriosis (EGE) are presented. Search terms for publications in Russian and English were used: «endometriosis», «endometriosis-associated ovarian neoplasia», «oncology», «rehabilitation».Results. Despite the fact that EGE is considered a benign disease, there is a risk for its malignant transformation. However, the pathogenesis and pathomorphological mechanisms of ЕАС are not yet fully understood.Conclusion. Active management of the rehabilitation period for women with EGE provides an opportunity for early diagnosing recurrences that will provide early diagnostics ovarian ЕАС and improve the main indicators of the quality of life for such patients.